(i) Field of the Invention
This invention relates to a magnetic, e.g., electromagnetic, operating table especially useful for laparoscopic surgery, and to a method of performing laparoscopic surgery using such operating table. It also includes novel ingestible materials for facilitating such electromagnetic laparoscopic surgery.
(ii) Description of the Prior Art
A most basic concept of surgery is one in which energy is imparted to tissues within the body. Of course, this energy is directed in exact ways to achieve a desired effect for that particular procedure.
Surgery continues to develop based partially on science, but is significantly anchored by tradition. Traditionally, surgery has been performed by the use of mechanical energy to manipulate tissue. Any clamping, grasping, cutting, or tying of tissues is effectively mechanical energy applied to that tissue. However, entire spectrums of energy remain unused and unexplored.
Energy spectrums available for consideration in surgery include tissue manipulation by the following means: mechanical (most widely used); electrical/heat (e.G., Electrocautery); pressure (e.G., Insufflation; suction); light (unused); radio (unused); magnetic/electromagnetic (unused); sound (unused); kinetic (unused); and chemical/molecular (unused).
Laparoscopic surgery is slowly changing the way surgery in the abdomen is done. Instead of large incisions, multiple thin, long-handled instruments and one long camera scope are placed through very small (2-3 mm) incisions. Surgery is done using the television view (provided by the camera scope) in conjunction with the long-handled instruments that extend from the surgical site, outside the body, and to the surgeon's hand. Such mini incisions greatly decrease surgical complications and post surgical recovery periods. In this type of surgery, manipulation is performed by means of thin instruments extending from within the body to outside the body, thus eliminating the need for full abdominal incisions. A long camera scope is used to visualize surgical manipulations within the body.
Currently, the intestine is adjusted laparoscopically using long gripping instruments. This method is quite tedious and time consuming. It would therefore be an improvement if the intestine could be adjusted by the use of magnetic means following the ingestion of magnetic or magnetizable materials.
The concept of the use by ingestion or otherwise of magnetic or magnetizable materials in medical and/or surgical techniques is known. For example U.S. Pat. No. 2,671,451 patented Mar. 9, 1959 by S. J. Bolger, titled "Remedial Pill", provided a remedial pill comprising a remedial substance which was soluble in the human body and a magnetically attractable metallic element associated with the substance. In use, a magnet was applied to the exterior of the body and the remedial pill was ingested. The pill travelled to the area of the magnet, where it was attracted and held. The remedial substances then dissolved. This patent is not concerned with manipulation of the intestines, e.g., retraction suspension or longitudinal translation of intestine segments to ease the performance of laparoscopic surgery. On the other hand, this patent is merely directed to the treatment of localized disorders of the alimentary canal, particularly ulcers where it was very difficult to apply a remedy to the affected spot for the reason that there was a constant flow through the canal caused by the normal digestive processes.
U.S. Pat. No. 3,043,309 patented Jul. 10, 1962 by H. F. McCarthy, titled "Method of Performing Intestinal Intubation", provided a method and means for performing intestinal intubation. The method involved securing a magnetic member to the tip of an elongated, X-ray opaque, flexible tube. The tip and tube were then passed through the oesophagus to the stomach of a patient. The stomach region was then illuminated by means of X-rays, and the tube was observed on a fluoroscopic screen. A maneuverable magnetic field was then applied to the magnetic material to direct the tip, to which the magnetic material was secured, to the pylorus valve in the stomach. A highly flexible intubation tube was adapted to pass through the intestinal tract of a patient. A magnet was positioned in the tip of the intubation tube. An electromagnet was provided for generating a magnetic field which coupled the magnet in the intubation tube and developed an attractive or repulsive force on the magnet, whereby the intubation tube could be directed in a predetermined direction. However, this patent is not directed to manipulation of the intestines, e.g., retraction suspension or longitudinal translation of intestine segments to ease the performance of laparoscopic surgery. This patent is merely directed to intestinal intubation, including an electromagnetic means which made it suitable for manual manipulation during an intubation operation.
U.S. Pat. No. 3,474,777 patented Oct. 28, 1969 by F. H. J. Figge et al, titled "Method of Administering Therapeutic Agents" provided a method of localizing a therapeutic agent at a preferred treatment site within an organism by injecting the agent into the organism in association with a magnetically-responsive substance. The agent and substance were concentrated at the preferred treatment site by the application of magnetic fields to the organism. Microcapsules and/or particles adaptable to injection and having a maximum size of five microns included a therapeutic agent in association with a magnetically responsive substance. The patent taught that the magnetically responsive substance may be coated with, or dispersed within, a therapeutic agent or, conversely, that a magnetically-responsive substance may be used to coat or partially coat a therapeutic agent, or as a matrix for the agent. When the particles were employed in the form of microcapsules, the magnetically-responsive substance could be within the capsule shell, or the magnetic substance could form part of a shell encapsulating a therapeutic agent. However, this patent is not directed to manipulation of the intestines, e.g., retraction suspension or longitudinal translation of intestine segments to ease the performance of laparoscopic surgery. On the other hand, this patent is only concerned with the provision of means for localizing therapeutic agents within the organism at those sites specifically desired to be treated with the therapeutic agent, without being dispersed generally throughout the organism.
U.S. Pat. No. 3,794,041 patented Feb. 26, 1974 by E. H. Frei et al, titled "Gastrointestinal Catheter" provided a gastrointestinal catheter of elongated flexible shape, including ferromagnetic material. When the catheter was inserted into the cavity of a body part, it would be attracted by a magnet external of the body in order to manipulate the body part with the catheter. The ferromagnetic material included a plurality of ellipsoidal beads of soft iron in the catheter in closely adjacent spaced relationship therein over a substantial length thereof. The soft iron ellipsoidal beads were fixed in the relationship by the resiliency of the flexible tubular members. The patentee further taught the provision of a coating of plastic, e.g., polyethylene, of adequate thickness, on the iron beads. In use, the gastrointestinal catheter was adapted, when inserted into the cavity of a body part, to be uniformly and unidirectionally attracted by a magnet external of the body for desired displacement of the body part substantially without the application of torque to the beads. However, this patent is not directed to manipulation of the intestines, e.g., retraction suspension or longitudinal translation of intestine segments to ease the performance of laparoscopic surgery. On the other hand, this patent is only concerned with a solution to the problem that, in certain types of disease, the only effective treatment consists of massive irradiation of the afflicted organ by concentrating the treatment at that organ.
U.S. Pat. No. 4,364,377 patented Dec. 21, 1987 by F. W. Smith, titled "Magnetic Field Hemostasis" taught a method for staunching blood flow from a bleeding gastrointestinal lesion. The method included introducing, into the gastrointestinal tract, a suitable tamponading mass having ferromagnetic properties. One such suitable tamponading mass was a mixture of finely divided iron particles and vegetable oil which may be introduced through an endoscopic catheter. Once in the gastrointestinal tract, the tamponading mass was moved as necessary to cover and press upon the bleeding lesion by a magnetic field generated outside the body, e.g., by an electromagnet. The positioning was under the direct visual control of the endoscopist. However, this patent is not directed to manipulation of the intestines, e.g., retraction suspension or longitudinal translation of intestine segments to ease the performance of laparoscopic surgery. On the other hand, this patent is only concerned with the difficulties of stopping the bleeding of gastrointestinal lesions such as acutely bleeding ulcers.